A new clinical trial has shown that planned birth at term can lower the risk of pre-eclampsia in women identified as high-risk, without leading to higher rates of emergency Caesarean sections or admissions to neonatal units.
The PREVENT-PE trial, led by researchers from King's College London and King's College Hospital NHS Foundation Trust, is the first study to demonstrate that screening for pre-eclampsia risk at 36 weeks of pregnancy and then offering early term delivery based on this assessment can reduce the occurrence of pre-eclampsia by 30% compared with standard care.
The research was funded by the Fetal Medicine Foundation (FMF) and included over 8,000 participants recruited from King's College Hospital and Medway NHS Foundation Trusts. Women were randomly assigned either to an intervention group, which received a risk assessment for pre-eclampsia followed by planned early term delivery if needed, or to a control group receiving usual care.
Risk assessment was performed using an FMF-developed model that combined maternal demographics, medical history, blood pressure measurements, and specific blood markers. Women identified as high-risk were offered planned births between 37 and 40 weeks of pregnancy. Those at low risk continued with usual hospital care in line with UK standards.
Pre-eclampsia is a form of high blood pressure that typically develops after 20 weeks of pregnancy or shortly after childbirth. The condition affects up to 8% of pregnancies worldwide and contributes significantly to maternal and newborn deaths each year.
Professor Kypros Nicolaides, founder and chairman of the Fetal Medicine Foundation and senior author of the study, said: "A 30% reduction in term pre-eclampsia, from 5.6% to 3.9%, is very important. It represents an even greater reduction in the number of pre-eclampsia cases than we can achieve for preterm pre-eclampsia with aspirin."
Dr Argyro Syngelaki, Reader in Maternal-Fetal Medicine at King's College London and co-lead author, noted: "This trial took place in busy NHS maternity units serving a highly diverse population, and often socially deprived communities where the burden of pre-eclampsia is greatest. The high level of participation and adherence shows that a personalised, risk-based approach is acceptable, practical, and aligns with what women want from their care. Achieving a 30% reduction in term pre-eclampsia, without increasing emergency Caesarean birth or neonatal admissions, represents a meaningful and reassuring improvement for women, babies, and maternity services."
Professor Laura A. Magee from King's College London added: "We will soon report on the health economic implications of the trial, as well as the experiences of women and staff who participated, to provide policy-makers with the information that they need to implement the trial intervention within the NHS."
The results were published in The Lancet.
